Abstract

To create a preliminary approach to a clinically important classification of scoliosis in adult patients.

Summary of Background Data.

There is currently no accepted classification of scoliosis in adults. High prevalence rates of scoliosis in the elderly and recent studies of health impact support the need for a clinically relevant classification.

Methods.

A total of 98 adult patients with scoliosis with a 2-year minimum treatment/follow-up were included. Patients were classified into one of 3 types of deformity based on the degree of lordosis (L1–S1) and frontal plane endplate obliquity of L3 on standing radiographs: type I = lordosis >55°, L3 obliquity <15°; type II = lordosis 35°–55°, L3 obliquity 15°–25°; and type III = lordosis <35°, L3 obliquity >25°.

A simple classification of adult scoliosis was developed based on frontal and sagittal plane standing radiographs. With increasing type (from I to III), self-reported pain and disability increased. This result was reflected in the treatment approach as well, with surgical rates increasing from types I to III. Further refinement is important to develop an all inclusive and sufficiently descriptive system.